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Human Hepatoma Associated Antigens: Opportunities for Immunotherapy

  • Chapter
Immunology of Liver Disease

Part of the book series: Immunology and Medicine Series ((IMME,volume 21))

Abstract

Hepatocellular carcinoma (HCC), one of the most common neoplasms worldwide, is still intractable1’2. HCC has a heterogeneous clinical presentation in different geographical locations. Unifocal tumours, more common in Japan and China, are occasionally resectable; usually when their diameter is smaller than 5 cm and depending on the presence of underlying liver disease. In contrast, unifocal tumours of larger diameter, or multifocal tumours — which are common in Africa, the Mediterranean Basin, and elsewhere — are usually surgically intractable. Chemotherapy is of very little use, and the overall response rate to systemic administration of adriamycin, 5-fluorouracil or cis platinum, is extremely poor’. Meta analysis of 11 studies in 444 patients treated with adriamycin revealed an overall response rate of 21%, with a calculated median survival of only 12 weeks’. Intra-arterial injection of such agents into the hepatic artery did not improve survival significantly3’4. Tumour site directed injection via the hepatic artery of the poppyseed oil, lipiodol, in suspension with adriamycin, mitomycin C, or cis platinum, followed by hepatic artery embolization, provides some palliation when surgery is contraindicated5. An alternative way for palliation of small tumours employs ultrasound-guided intralesional alcohol injection directly into small tumours6’. Other forms of immunotherapy, such as administration of a-interferon, interleukin-2 with LAK cells, or tumour necrosis factor8-13, have so far been disappointing. Liver transplantation, previously believed to offer some hope for patients with small and localized HCC’“, cannot be considered a realistic mode of therapy for the hundreds of thousands

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  1. D. Shouval
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  2. R. Adler
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  1. Department of Medicine, St Mary’s Hospital Medical School, London, UK

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Shouval, D., Adler, R. (1994). Human Hepatoma Associated Antigens: Opportunities for Immunotherapy. In: Thomas, H.C., Waters, J. (eds) Immunology of Liver Disease. Immunology and Medicine Series, vol 21. Springer, Dordrecht. https://doi.org/10.1007/978-94-011-1428-8_5

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